Precision medicine in inflammatory bowel diseases

Inflammatory bowel diseases comprising Crohn's disease and ulcerative colitis have emerged as global diseases. Multiple distinct therapeutic mechanisms have allowed us to increase our rates of achieving remission and reducing permanent diseaserelated morbidity. However, there is limited data to inform relative positioning of different therapies. This review will summarize existing literature on use of clinical decision models to inform relative efficacy of one therapeutic mechanism compared to the other given individual patient characteristics. It will also demonstrate the value of serologic, transcriptomic (from biopsies), and microbiome-based biomarkers in identifying which therapy is most likely to work for a given patient. We will review the existing gaps in the literature in this field and suggest a path forward for future studies to better inform patient care, incorporating the principles of precision medicine in the management of inflammatory bowel disease. (Intest Res, Published online )

Automated summary

Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, are common global diseases. Limited data is available to determine the relative positioning of different therapies. This review summarizes existing literature on the use of clinical decision models to compare and evaluate the relative efficacy of various therapeutic mechanisms based on individual patient characteristics. It also highlights the significance of serologic, transcriptomic, and microbiome-based biomarkers in determining the most suitable therapy for individual patients.